NPIMap

Organization Active NPI

Peres Elementary School

  • Dentist
  • Richmond, CA
National Provider Identifier
1962749861
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
23569 Issued in CA
Legal business name
PERES ELEMENTARY SCHOOL
Practice address
719 5TH St
Richmond, CA 94801-2654
Phone
(510) 231-1407
NPI assigned
Jan 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniel S. Tanita, DDS
Title
Dentist
Phone
(510) 236-1661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 23569 CA Primary

Addresses

Primary practice location

719 5TH St
Richmond, CA 94801-2654

Mailing address

719 5TH St
Richmond, CA 94801-2654
Phone (510) 231-1407

Other identifiers 1

IdentifierTypeStateIssuer
G93840-01OtherCADENTI-CAL

National Provider Directory

National Provider Directory
Tax ID family
Peres Dental Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1962749861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 5TH ST",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948012654",
            "telephone_number": "510-231-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 5TH ST",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948012654",
            "telephone_number": "510-231-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERES ELEMENTARY SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "TANITA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "510-236-1661",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "23569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G93840-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.